Deck 3: AACN Cardiac Vascular Nursing

Question 1

A nurse is taking care of a patient who has undergone pacemaker implantation. What investigations should the nurse order for this patient?

A)Exercise ECG testing, echocardiogram, CT scan of chest
B)Electrocardiogram, echocardiogram, chest X-ray
C)Exercise ECG testing, stress echocardiogram, chest X-ray
D)Echocardiogram, coronary angiography, chest X-ray

Answer 1

Electrocardiogram, echocardiogram, chest X-ray

Question 2

What is the basis of pacing of atria and ventricles in rate modulated pacing?

A)Intrinsic heart rate
B)Keep pacing at a constant rate
C)Physiological stress with increased heart rate
D)Pacing only when demand of body increases during exercise

Answer 2

Physiological stress with increased heart rate

Question 3

Which of the following anti-dysrhythmic class of drugs is not correctly matched with its mechanism of action?

A)Class II - Potassium channel openers
B)Class I - Inhibition of sodium channels
C)Class III - Inhibition of potassium efflux
D)Class IV - Calcium channel blockers

Answer 3

Class II - Potassium channel openers

Question 4

The fibrinolytic mechanism of streptokinase and urokinase are:

A)Inhibit the formation of fibrin by disrupting the conversion of plasminogen to plasmin and activate the conversion of fibrin-bound plasminogen to plasmin respectively
B)Both inhibit the formation of fibrin by disrupting the conversion of plasminogen to plasmin
C)Both activate the conversion of fibrin-bound plasminogen to plasmin
D)Both act directly on fibrin to dissolve it

Question 5

Which leadership style involves a vision and commitment to meet a team's goals?

A)Autocratic
B)Laissez-faire
C)Transactional
D)Transformational

Question 6

In which leadership style is the democratic process used for decisions among team members?

A)Laissez-faire
B)Participative
C)Transactional
D)Transformational

Question 7

Which of the following is not a possible disciplinary action measure which can be taken if a nurse is found guilty of misconduct?

A)Suspension of license for a specified period of time
B)Prosecution
C)Prohibition of work in specified settings
D)Revocation of license

Question 8

Which of the following are non-cardiac causes of pulmonary edema?

A)Malaria fever, carbon monoxide poisoning, vasovagal syncope
B)Urinary tract infections, decompression sickness, exposure to carbon monoxide
C)Lung infections, high altitude, acute respiratory syndrome
D)Disease of pulmonary artery, asthma, COPD, Yellow fever

Question 9

The nurse records the EKG of an asymptomatic patient. Which of the following EKG findings confirms the diagnosis of Wenckebach phenomena?

A)No definite relation between P-wave and QRS complex
B)Progressive lengthening of PR interval followed by a P wave without an associated QRS complex
C)Prolonged PR interval with narrow QRS complex
D)Prolonged PR interval with wide QRS complex

Question 10

Which of the following correctly represents the pathophysiologic mechanism behind development of cor pulmonale?

A)Pulmonary vasodilatation, compromise of vascular bed due to lung disease such as emphysema and interstitial lung disease, thinning of blood due to anticoagulants and primary pulmonary hypertension
B)Pulmonary vasoconstriction, compromise of vascular bed due to lung disease such as emphysema and interstitial lung disease, increased blood viscosity due to diseases like sickle cell anemia and primary pulmonary hypertension
C)Pulmonary vasodilatation, compromise of vascular bed due to lung disease such as emphysema and interstitial lung disease, valvular heart disease and primary pulmonary hypertension
D)Pulmonary vasoconstriction, compromise of vascular bed due to vascular diseases, increased blood viscosity due to diseases like sickle cell anemia and primary pulmonary hypertension

Question 11

Which of the following conditions is not an example of acute inflammation?

A)Acute appendicitis
B)Tuberculosis
C)Acute tonsillitis
D)Acute gout

Question 12

A 75-year old diabetic, obese male patient presenting with complaints of intermittent palpitation and excessive sleepiness during daytime was advised 24-hour Holter monitoring. The nurse is explaining to the patient about the diagnostic significance of Holter monitoring. Which of the following cannot be determined by Holter monitoring?

A)Detection of arrhythmia
B)Correlation of symptom with arrhythmia
C)Cause of excessive sleepiness during daytime
D)Detection of myocardial ischemia

Question 13

Which of the following murmurs is not audible while auscultating a patient of aortic regurgitation?

A)Early diastolic decrescendo murmur
B)Systolic ejection murmur
C)Austin Flint murmur
D)Crescendo-decrescendo murmur

Question 14

How many positions does the generic pacemaker code have?

A)1
B)5
C)3
D)7

Question 15

A nurse records an EKG of an asymptomatic person coming for routine check-up. After looking at the EKG, which of the following findings might the nurse say that there is nothing wrong with the EKG?

A)PR interval of 210 milliseconds
B)Fibrillatory waves
C)ST-T changes in precordial leads
D)Saw-tooth pattern

Question 16

Which of the following is a characteristic feature of syndrome X?

A)Severely abnormal angiogram and symptoms of angina
B)Normal ECG exercise testing but abnormal findings on echocardiogram
C)Prognosis is worst in these patients
D)Patient presenting with typical symptoms of angina but normal angiogram

Question 17

You are working as RN in cardiac emergency. Which patient would you see first?

A)A patient with a history of deep vein thrombosis presenting with acute onset dyspnea and pink frothy sputum
B)A patient presenting with exertional chest pain for last one month
C)A patient with hypertension on regular medication presenting with postural giddiness
D)A patient who has come from the medicine ward with an exacerbation of CHF requiring IV furosemide

Question 18

The following patients arrived in emergency room and you are the attending cardiac nurse. Assessment of which of the following patients is a priority?

A)70-year old male patient with left sided chest pain radiating to left arm accompanied by profuse sweating
B)Young female complaining of palpitation and sleeplessness during night
C)14-year old male complaining of chest pain at rest not radiating to arm or neck and fever for last one week.
D)40-year old female complaining of chest pain on exertion

Question 19

You are working in cardiac ICU as RN and have to take care of patients with cardiac arrhythmia. Which of the following patients will you attend first?

A)A patient of ventricular tachycardia
B)A patient showing first degree heart block
C)A patient showing atrial fibrillation
D)A patient of recent myocardial infarction showing occasional ventricular ectopics

Question 20

A nurse is explaining about foot care to a patient being discharged with peripheral vascular disease . Which of the following information should be included in instructions?

A)Walk barefoot during morning walks
B)Use a heating pad to keep feet warm
C)Avoid keeping legs crossed
D)Use antibacterial ointment to treat small cuts on skin to prevent infection

Question 21

A patient is being discharged from hospital seven days post myocardial infarction. He is curious to know why he must wait six weeks before having sexual intercourse. What is the best response by the nurse to this question?

A)"You need to regain your strength before attempting such exertion."
B)"When you are able to climb two flights of stairs comfortably, it is generally safe to have sex."
C)"Have a glass of wine to relax you, before you can try to have sex."
D)"If you can maintain an active regular morning walks, your risk will decrease."

Question 22

A nurse is assisting a physician in treating a patient with ventricular tachycardia. Which of the following drugs should the nurse anticipate that the doctor would prescribe?

A)Amiodarone
B)Sodium Bicarbonate
C)Vitamin K
D)Dopamine

Question 23

A patient with cyanosis is admitted to the emergency room without a diagnosis. Which of the nursing action is a priority in relation to oxygen administration?

A)Wait for the lab reports
B)Wait for the physician to order oxygen administration
C)Administer oxygen at 2 liters flow per minute
D)Administer oxygen at 10 liters flow per minute and check the oxygen saturation of the patient

Question 24

A patient arrives in the ER complaining of substernal chest pain, profuse sweating and shortness of breath. His vital signs are as follows: Temperature 37 C; HR 110; BP 160/100 mmHg; Respiration 30. Which of the following includes the immediate treatment of the patient?

A)Oxygen, sublingual nitroglycerin, followed by morphine if the nitroglycerin fails to relieve the pain
B)Oxygen, morphine, aspirin followed by sublingual nitroglycerin if morphine fails to relieve the pain
C)Oxygen, aspirin, sublingual nitroglycerin, no morphine due to elevated BP
D)None of the above

Question 25

A patient diagnosed with heart failure is receiving digoxin (Lanoxin) and furosemide (Lasix). During the morning rounds, the patient complains of nausea and yellow vision. Which of the following nursing actions is a priority?

A)Continue with the drug administration
B)Give digoxin only
C)Check serum potassium level
D)Check the serum digoxin level

Question 26

Which of the following statements does not abide by the nurses' code of ethics?

A)The nurse's main commitment is to the patient
B)The nurse is not supposed to collaborate with other healthcare professional while caring for patients
C)The nurse is an advocate for the patient and aims to protect the health, safety, and rights of the patient
D)The nurse is responsible for preserving the integrity and safety of the patient

Question 27

Which of the following models of team effectiveness views the team as components of a whole?

A)Cognitive motivational model of team effectiveness
B)Traditional model of team effectiveness
C)Interventional model of team effectiveness
D)Philosophical model of team effectiveness

Question 28

A patient is scheduled to undergo cardiac catheterization. He says to the nurse: "I am so afraid of the outcome of this surgery." What is the best response of the nurse?

A)I believe you're in good hands. Your surgeon is one of the best.
B)Why are you afraid?
C)You must have faith and look on the bright side.
D)Tell me what concerns you have on this surgery.

Question 29

A nurse is caring for a patient on digoxin therapy. It is the responsibility of the nurse to know the signs and symptoms of digoxin toxicity. Which of the following is correct?

A)Halo effect on vision, ventricular bigeminy, PVC, anorexia
B)Bradycardia, nausea, vomiting, headache
C)PVC, anorexia, ventricular bigeminy, bleeding
D)Tachypnea, anorexia, PVC, nausea

Question 30

Cardioversion is an electrical current administration used to convert certain dysrhythmias to normal rhythm. This procedure is most effective when the patient demonstrates:

A)Ventricular Fibrillation
B)Ventricular Tachycardia
C)Ventricular Standstill
D)Torsades de Pointes

Question 31

A patient arrives in the ER and was diagnosed with angina pectoris. After taking 2 sublingual nitroglycerin tablets for chest pain, the patient states that the chest pain is relieved but he is now complaining of headache. The nurse should inform the patient that:

A)Headache is an expected side effect of the medication.
B)Headache indicates drug toxicity.
C)Patient is indicating a hypersensitivity to the drug.
D)Headache is an expected adverse effect of the medication.

Question 32

Graham Steell murmur is heard in which of the valvular diseases?

A)Aortic stenosis
B)Pulmonic stenosis
C)Pulmonary regurgitation
D)Aortic regurgitation

Question 33

Which of the following criteria is not used to diagnose Buerger's disease?

A)Individuals younger than 45 years of age
B)Past or present tobacco use
C)Pain in muscles on walking
D)Presence of ischemic ulcers and gangrene in distal extremity

Question 34

A 72-year old male patient has been diagnosed to have peripheral arterial disease. What are the contraindications of percutaneous transluminal angioplasty of the lower extremity in this patient?

A)Hypertensive patients of poor ventricular function
B)Patients having dyslipidemia
C)Medically unstable, diabetic patient, long arterial occlusion, poor distal run off
D)Patient who has undergone coronary angioplasty

Question 35

Which of the following approaches are not used for reducing triglyceride levels?

A)Omega-3 fatty acids
B)Antiplatelets
C)Nicotinic acid
D)Statins

Question 36

A patient with atrial fibrillation is presents with acute pain in left lower limb which progressed to loss of sensation and feeling of cold and numbness over few hours. What is the first treatment the nurse should start?

A)Prepare the patient for embolectomy
B)Immediate heparinization
C)Send the patient for arteriography
D)Identify and treat the underlying cause

Question 37

Pericardial fluid has been aspirated and examined from a patient presenting with pericardial effusion. The fluid examination report shows a transudative fluid. Which of the following is unlikely to be the cause of this pericardial effusion?

A)Hypoalbuminemia/hypoproteinemia
B)Congestive heart failure
C)Aortic dissection
D)Hypothyroidism

Question 38

Holter monitoring of a 65-year old female patient having cervical carcinoma stage 3 shows ventricular tachycardia resulting in syncope. The condition is treatable by implantable cardio-defibrillator. Which of the following is a contraindication of use of ICD in this patient?

A)Cervical carcinoma stage 3
B)Ventricular tachycardia
C)Age > 60 years
D)Female gender

Question 39

Which of the following is a correctly matched correlation of jugular venous pulse?

A)Loss of "a" wave: atrial fibrillation
B)Slow "y" descent: constrictive pericarditis
C)Giant "a" waves: tricuspid regurgitation
D)Sharp "y" descent: mitral valve prolapse

Question 40

A 65-year hypertensive non-smoker male patient has an abnormal lipid profile. What lifestyle modification should the nurse advise to this patient?

A)Restriction of physical activity, dietary supplementation
B)Physical exercise, healthy diet, control of blood pressure
C)Physical exercise, healthy diet, dietary supplementation,
D)Restriction of physical activity, diet rich in saturated fat

Question 41

Which of the following statements are not true about sick sinus syndrome?

A)Sick sinus syndrome is caused due to structural sinoatrial node disease
B)Treatment is pacing for bradycardia and medicines for tachycardia
C)It may present as complete heart block
D)It may present as tachy-brady syndrome

Question 42

A patient presents with complaints of palpitations and loss of weight. Blood investigations show thyrotoxicosis. Which of the following murmurs are expected to be heard on auscultation?

A)Diastolic murmur
B)Soft systolic murmur
C)Flow murmur
D)Crescendo-decrescendo murmur

Question 43

The bypass pathway known as bundle of Kent is present in Wolf-Parkinson-White syndrome. Which anatomical structures are connected via the bundle of Kent?

A)Sinoatrial node and atrioventricular node
B)Sinoatrial node and ventricle
C)Atria and ventricle
D)Atrioventricular node and ventricle

Question 44

Jones criteria are for diagnosis of which of the following diseases?

A)Typhoid fever
B)Rheumatic fever
C)Yellow fever
D)Dengue fever

Question 45

Which of the following pharmacologic agents are not used for treatment of metabolic syndrome?

A)Lipid-lowering agents
B)Antihypertensives
C)Oral antidiabetic agents and insulin
D)Antibiotics

Question 46

Which of the following is not a part of major criteria of the modified Jones criteria for diagnosis of rheumatic fever?

A)Pancarditis
B)Erythema marginatum
C)Subcutaneous nodules
D)Polyarthralgia

Question 47

A patient presenting to emergency room was diagnosed to have acute myocardial infarction. Which of the following measures should the nurse be prepared to take in the emergency room?

A)Sedation, thrombolysis with streptokinase, echocardiography,
B)ECASA 325 mg chewed stat, oxygen, sublingual nitroglycerine, morphine, sedation, venodilation and ß blockers
C)Morphine for pain relief, oxygen inhalation, endotracheal intubation
D)ECASA 325 mg chewed stat, DC cardioversion, positive pressure ventilation

Question 48

The vascular changes of acute inflammation consist of the following:

A)Vasodilation, increased blood flow, recruitment of lymphocyte
B)Vasodilation, increased permeability, reduced blood flow
C)Vasoconstriction, increased blood flow, decreased endothelial permeability
D)Vasoconstriction, reduced blood flow, decreased endothelial permeability

Question 49

Which of the following set of symptoms is correctly matched with the location of the aneurysm?

A)Brain - severe headache, blurred vision, pain around eye
B)Brain - loss of memory, slowness of movement
C)Lower limb - muscle paralysis, tremors in feet
D)Abdomen - nausea, vomiting, loss of sensation

Question 50

Which of the following sets of medications is used in treatment of Raynaud's disease?

A)Calcium channel blockers, alpha blockers, vasodilators
B)Beta blockers, vasodilators, lipid lowering agents
C)Alpha blockers, lipid lowering agents, antioxidants
D)Calcium channel blockers, alpha and beta agonists

Question 51

The false statement about stroke is:

A)Stroke is of two types: ischemic and hemorrhagic
B)Ischemic stroke occurs when a blood clot forms in arteries supplying the brain
C)Embolic stroke occurs when a blood clot forms in arteries supplying the brain
D)Hemorrhagic stroke occurs when a blood vessel ruptures and leaks into the brain

Question 52

Which of the following sets of conditions during pregnancy increases the risk of developing atrial septal defect in fetus?

A)Rubella infection, poorly controlled diabetes, and illicit drug or alcohol abuse
B)Measles infection, infective endocarditis, vasculitis
C)Pregnancy induced hypertension, proteinuria
D)Congenital syphilis, smoking, hyperemesis gravidarum

Question 53

The nurse is taking care of a 50-year old patient who has undergone mitral valve replacement surgery. Patient suffers from perioperative myocardial infarction, doctor recommends continuous intravenous infusion of nitroglycerine. About which of the following parameters should the nurse be closely watchful?

A)Start medication using infusion pump
B)Frequent monitoring of urine output
C)Frequent monitoring of blood pressure
D)Send for serum potassium

Question 54

Which of the following cardiac arrhythmias is most serious, and for which emergency defibrillation is often necessary to prevent sudden death?

A)Atrial flutter
B)Atrial fibrillation
C)Paroxysmal supraventricular tachycardia
D)Ventricular fibrillation

Question 55

Which of the following statements is not true about Wolf-Parkinson-White syndrome?

A)Wolf-Parkinson-White syndrome occurs due to formation of extra circuit inside heart
B)Wolf-Parkinson-White syndrome is common in elderly patients
C)Wolf-Parkinson-White syndrome is more common in men than in women
D)Incidence of Wolf-Parkinson-White syndrome highest in people of age group 30 to40

Question 56

A nurse is examining a patient with constrictive pericarditis. Which of the following findings is not expected in this patient?

A)Pulsus paradoxus
B)Kussmaul's sign
C)Raised jugular venous pressure
D)Slow "y" descent

Question 57

Which of the following does not correctly match the site of peripheral thromboembolectomy with the appropriate surgical approach?

A)Femoral occlusions - bilateral ventricle groin incisions
B)Aortic occlusions - bilateral ventricle groin incisions
C)Iliac occlusions - bilateral ventricle groin incisions
D)Popliteal occlusions - incisions in the distal common femoral artery

Question 58

Which of the following is not a correct pair of the signs of chronic aortic regurgitation and the organ where it is demonstrated?

A)Corrigan's pulse - carotid artery
B)Mueller sign - liver
C)Quincke's sign - nail bed
D)Duroziez's test - femoral artery

Question 59

Which of the following sets of drugs might slow the conduction through AV node and cause second degree heart block?

A)Digoxin, statins, nitrates
B)Procainamide, statins, fibrates
C)Digoxin, beta-blockers, calcium channel blockers
D)Calcium channel blockers, potassium channel openers

Question 60

A patient who has been diagnosed with aneurysm in femoral artery during routine screening wants to know about the available treatment options. What the nurse should explain this patient regarding treatment?

A)No treatment is necessary
B)Follow up every month
C)Immediately undergo surgery
D)Undergo angioplasty if aneurysm starts causing symptom

Question 61

A patient has been diagnosed with aortic aneurysm of abdominal aorta having a diameter of 3.5 cm. What advice should the nurse give this patient about follow-up?

A)Come for follow up every year
B)Come for follow up after 5 years
C)Come for follow up every 2-3 years
D)No need to come for follow up

Question 62

The incorrect statement about Buerger's disease is:

A)Buerger's disease is a rare disorder
B)Complications of the disease are ulcerations, infections, and gangrene
C)The disease is more common in men than in women
D)Another name for the disease is Raynaud's disease

Question 63

Which of the following is true about atherosclerotic plaque formation?

A)Plaque formation is caused by an acute inflammatory response and endothelial dysfunction where lipids, cholesterol, and calcium build up in the arteries
B)Plaque formation is caused by a chronic inflammatory response and epithelial injury where lipids, cholesterol, and calcium build up in the arteries
C)Plaque formation is caused by a chronic inflammatory response and endothelial dysfunction where lipids, cholesterol, and calcium build up in the arteries
D)Plaque formation is caused by an acute inflammatory response and epithelial injury where lipids, cholesterol, and calcium build up in the arteries